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| DEFINITION
| | {{PreICD10 dx | NewDxArticle = Bacteremia }} |
| Septicemia is the presence of bacteria in the blood (bacteremia).
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| CRITERIA:
| | {{DX tag |Infection | Medical Problem | Septicemia (Bacteremia/Fungemia) | UPL (Universal Pathogen List) | 4600 - Septicemia (Bacteremia/Fungemia) | No | 0 | '''Critical Care and Medicine''' |Currently Collected | |}} |
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| Positive (+ ve) blood cultures
| | ==Definition== |
| | '''Septicemia/BACTEREMIA/Fungemia''' , (blood stream infection)-(BSI) means POSITIVE blood culture, (presence of pathogens in blood stream). |
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| *if the physician's diagnosis is septicemia but no blood cultures was sent, code as follows: | | == Guideline == |
| **septicemia (46)– subcode (92) –no blood culture sent | | * Positive (+ ve) blood cultures |
| | * [[Unknown Pathogen]] only used for septicemia if the patient was transferred from a hospital where positive blood cultures were found but it is unclear which organism it was because it was not included in the documentation sent with the patient. |
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| *if the physician diagnosis is septicemia and a blood culture was sent, code as follows:
| | ===Physician Recording Septicemia without +ve blood culture === |
| **septicemia (46) - subcode (64) - negative blood culture | | *If this happens it is best to ask the physician about this. Usually they mean septic not septicemia because they are still unsure of the source. |
| **septicemia (46) - subcode (68) - Unknown pathogen, if you are not clear which bug is causing the infection. | | * If a source is not identified by cultures then use [[Fever NYD]] |
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| Also see: [[Septic Shock]] or [[Severe Sepsis]]
| | === Alternate dx === |
| | * [[Severe Sepsis]] |
| | * [[Septic Shock]] |
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| | | [[Category:Sepsis]] |
| *[[User:TOstryzniuk|TOstryzniuk]] 18:48, 23 December 2008 (CST)
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| '''Examples''''
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| ''Physicians in general, follow their own varied and inconsistent guidelines when documenting the diagnosis of septicemia, severe sepsis or shock therefore it can be a challenge for data collectors particularly when the DX is septic shock or severe sepsis.'' The examples here provide a guideline for collectors on how to code. [[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| *When a patient has been admitted with '''urosepsis''' as an example, and has been determined by the physician to be '''septicemic''' and has received '''antibiotics before the blood cultures''' have been drawn and thereby affecting the results showing negative culture. Coding criteria for septicemia on page 10 of diagnosis code book is defined as "positive blood cultures".
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| '''**TRISH REPLY'''[[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| **1.septicemia (46) – subcode (65) –negative culture (if a blood culture was sent & no bugs) '''AND'''
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| **2.urosepsis(51) – subcode (65)- negative culture (if a urine culture was sent & no bugs) or subcode (92) –if no urine culture sent.''
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| *Also, physician are recording the diagnosis of '''septicemia''' even when '''blood cultures''' are '''negative''' (negative cultures even with no antibiotics given pre blood cultures draw).
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| **How do you want these patients captured?? Is capturing '''cystitis with a bug''', if found, adequate and '''septicemia''' should NOT be coded, or use code '''septicemia''' and subcode as '''“culture negative'''” if physician is calling it septicemia?
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| '''***Trish Reply'''[[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST).
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| ***1. ''septicemia (46) – subcode (65) –negative culture (blood culture was sent & no bugs ID'd).'' '''AND'''
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| ***2.''urosepsis (51) – subcode (XX) type of bug ID’d''
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| **If physician records the diagnosis of septicemia and that is their working diagnosis without a positive culture, do we code as septicemia subcode “negative culture”?
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| ''***Trish Reply:''[[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| ***septicemia (46) – subcode (65) –negative culture (if blood culture was sent & no bugs ID’d).
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| ***'''OR'''
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| ***''septicemia (46) – subcode (92) –no culture sent (if no blood culture was sent)''.
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| *A similar question in regards to the definitions for severe sepsis, and septic shock if applicable. We have seen people who NOT meet all the criteria, yet they are exhibiting signs of either severe sepsis, or septic shock, and that is what the Dr. has diagnosed and is treating..--JHutton 11:13, 25 June 2008 (CDT).
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| **TRISH REPLY:[[User:TOstryzniuk|TOstryzniuk]]10:20, 23 December 2008 (CST).
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| **''if this is the working DX that the physician is treating then this is what the collector must code as the DX''.
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| ==note==
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| *''If a patient doesn't meet the criteria for shock or severe sepsis to a tee then what would the DX be then? I don't expect a collector to make the DX or debating with the physician about it therefore code the physician's working DX for this problem. Of course if chart notes are really not clear you can ask the physician.
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| *FYI: We have a similar problem with the DX of ARF, CRF and ARI in that there is no consistent definition that physicians follow when documenting this DX in the charts. For renal failure DX, the collectors are asked to '''follow the collection guide''' regardless of what physician is charting. The collection guide criteria for the renal failure DX is simple, unlike the septic shock criteria.[[User:TOstryzniuk|TOstryzniuk]] 10:20, 23 December 2008 (CST)
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| [[Category:Diagnosis Coding]] | |
Legacy Content
This page is about the pre-
ICD10 diagnosis coding schema. See the
ICD10 Diagnosis List, or the following for similar diagnoses in
ICD10:
Bacteremia
Click Expand to show legacy content.
Definition
Septicemia/BACTEREMIA/Fungemia , (blood stream infection)-(BSI) means POSITIVE blood culture, (presence of pathogens in blood stream).
Guideline
- Positive (+ ve) blood cultures
- Unknown Pathogen only used for septicemia if the patient was transferred from a hospital where positive blood cultures were found but it is unclear which organism it was because it was not included in the documentation sent with the patient.
Physician Recording Septicemia without +ve blood culture
- If this happens it is best to ask the physician about this. Usually they mean septic not septicemia because they are still unsure of the source.
- If a source is not identified by cultures then use Fever NYD
Alternate dx